Trends in female representation in cardiology and its subspecialties: The current state and the desired state.

INTRODUCTION: Women have been historically underrepresented in Cardiology and its subspecialties. However, limited research has been done to examine the trends of representation of women in cardiology and its subspecialties over time. Our study aims to examine these trends and compare them to other internal medicine subspecialties. METHODS: We used data from the Accreditation Council for Graduate Medical Education (ACGME) to conduct a retrospective analysis of the gender trends of cardiology and its subspecialties over a decade from 2013 to 2023. Chi-square statistical testing was used to compare representation percentages across groups. A p-value <0.05 was considered statistically significant. RESULTS: Compared to all internal medicine subspecialties, cardiology and its subspecialties continues to remain the least represented by women. We found a statistically significant increase in women's representation in cardiovascular disease and interventional cardiology. However, there was no statistically significant changes in the representation of women in electrophysiology and advanced heart failure. We have found over the last decade that there was a positive trend in overall women fellows choosing cardiology and its subspecialties, especially since 2018. CONCLUSION: While strides have been made in increasing the number of female fellows in cardiology, it still lags compared to other internal medicine subspecialties. As we celebrate this minor milestone, it is crucial to emphasize the importance of persistently overcoming obstacles and fostering a supportive environment throughout all training phases to attract, retain, and mentor female trainees.

An electronic hand hygiene surveillance device: a pilot study exploring surrogate markers for hand hygiene compliance.

OBJECTIVE: To evaluate the feasibility of using an electronic hand hygiene surveillance and feedback monitoring device. DESIGN: A 2-phase pilot study included initial direct observation of hand hygiene practices as part of routine hospital quality assurance (phase I) and subsequent monitoring using an electronic hand hygiene surveillance device (phase II). SETTING: A 700-bed tertiary care teaching hospital. PARTICIPANTS: Phase I included a convenience sample of healthcare workers. Phase II included 7 medical interns and 7 registered nurses recruited through email and at work-related meetings. METHODS: During phase I, healthcare workers were directly observed at patient room entry and exit during the period April through November 2008. During phase II, hand hygiene data were gathered through indirect observation using the electronic device during a 4-week period in August 2009. Twenty patient rooms were fitted with electronic trigger devices that signaled a reader unit worn by participants when they entered the room, and 70 dispensers for liquid soap or hand sanitizer were fitted with triggers that signaled the reader unit when the dispenser was used. The accuracy of the devices was checked by the principal investigator, who manually recorded his room entries and exits and dispenser use while wearing a reader unit. RESULTS: During phase I, hand hygiene occurred before room entry for 95 (25.1%) and after room exit for 149 (39.4%) of 378 directly observed patient room visits, for a cumulative composite compliance rate of 32.3%. Among the 378 room visits, 347 (91.8%) involved contact with the patient and/or environment. During phase II, electronic monitoring revealed a cumulative composite compliance rate of 25.5%. The electronic device captured 61 (98%) of 62 manually recorded room entries and 133 (95%) of 140 manually recorded dispensing events. CONCLUSIONS: The electronic hand hygiene surveillance device seems to be a practical method for routinely monitoring hand hygiene compliance in healthcare workers.

An association between Takotsubo cardiomyopathy and thyroid storm.

A 65-year-old woman presented to the hospital with weight loss and diarrhea. A diagnosis of thyroid storm was established by the presence of fever, lethargy, tachycardia, heart failure (HF), and abnormal thyroid function tests. An acute coronary syndrome (ACS) was suspected because of anteroseptal ST-segment elevations on electrocardiogram and severe left ventricular (LV) dysfunction with apical dilation on echocardiogram. The ejection fraction (EF) was 25%. Treatment for ACS and HF was begun. Coronary arteriography revealed normal coronaries. Propylthiouracil and corticosteroids were added to treat thyrotoxicosis. On Day 4, repeat echocardiography confirmed an EF of 65% and complete resolution of LV dysfunction and cavity dilation. Reversible LV dysfunction and apical cavity dilation is consistent with Takotsubo cardiomyopathy. While commonly associated with psychological trauma, its association with thyroid storm has only been reported twice before. Knowledge of this possible association is of importance in establishing the diagnosis and instituting a proper treatment plan.